Background. Healthcare workers’ (HCWs) hands become progressively colonized with potential pathogens during their patient care and act as a vehicle for transmission of microorganisms to other patients. Hand hygiene is undisputedly one of the most effective infection control measures. The objective of this study was to measure the hand hygiene (HH) compliance among the doctors and nurses before and after intervention. Methodology. This quasi-experimental (before and after) study was conducted from July 2019 to July 2020 in the neonatal intensive care unit in a tertiary hospital in Bangladesh. The doctors and nurses were observed for their compliance to HH before and after the intervention. Several group discussions were arranged, and posters on HH were attached as reminders at the workstations during the intervention period. Binary logistic regression analysis of the predictors for the outcome as HH noncompliance was performed. Result. The overall compliance to HH was significantly increased in both before (from 42.9 to 83.8%, p = < 0.0001 ) and after (28.5 to 95.9%, p = < 0.000 ) patient contact, in both the case of high-risk and low-risk contacts ( p = < 0.000 ) following the intervention. A significant reduction in the frequency of inadequate HH (20.2 to 9.7%, p = .000) was documented. In logistic regression analysis, compliance to HH was found more after the intervention (aOR = 13.315, 95% CI: 7.248–24.458). Similarly, being a physician (aOR = 0.012, 95% CI: 0.005–0.030) and moments after patient contact (aOR = 0.114, 95% CI: 0.049–0.261), significant positive predictors for compliance to HH were found. Conclusion. Significant improvements in HH compliance were achieved through a systemic, multidimensional intervention approach among the doctors and nurses in an intensive newborn care setting.
Background: Of the annual 2.5 million global neonatal deaths, most occurring in developing countries, and one-third to one half are attributed to infections. In low-income countries like Bangladesh, where home delivery is common and attendance by skilled personnel is low, many babies are born in unhygienic conditions and infections of the umbilical cord stump are common. Exposure of the freshly cut umbilical cord stump to pathogens may lead to local cord infections (omphalitis) that may progress to systemic infection and death. Objective: To evaluate the pattern of umbilical cord care practices and the rate of development of omphalitis. Methodology: It was a prospective observational study included 80 neonates. This study was conducted over a period of six months from May to November 2013 in the obstetrics unit of department of obstetrics and gynaecology, Sher-E-Bangla Medical College Hospital, Barisal. Results: A total 80 out born neonates, accompanying their mothers who were admitted due to their post-partum complications from home delivery, were included in this study. Among them twelve (15%) were found to have omphalitis, of which nine (11.25%) were with mild omphalitis and three (3.75%) with moderate omphalitis. Umbilical cords were mostly (58.75%) cut by used shaving blades and tied by washed thread from home (88.75%). Most of the caregivers (65%) had educational qualification below primary level. Forty-two (52.5%) of the eighty caregivers had not heard about WHO recommended dry cord care method. All of the caregivers applied traditional substances to the cord and mustard oil was the commonest (75%) practice. It was applicable in all omphalitis cases. Statistically significant relationship (p < 0.05) was found with omphalitis and cord cutting instrument, topical application of traditional substances to the cord, caregivers’ educational status and knowledge about dry cord care. Conclusion: Omphalitis rate among enrolled newborn was 15% cutting cord with unsterile instruments, applying traditional substances to the cord and low educational status among the care givers are related with development of omphalitis.
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